A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

Rationale: A. 167 mEq/L: This indicates hypernatremia, which is typically associated with fluid volume deficit due to water loss, not fluid overload. B. 142 mEq/L: This is a normal sodium level and does not indicate fluid imbalance on its own. C. 136 mEq/L: Also within the normal reference range (135–145 mEq/L) and does not signal fluid excess. D. 116 mEq/L: This level represents severe hyponatremia, commonly seen in fluid volume excess. In conditions like heart failure or renal failure, water retention can dilute serum sodium. The patient’s symptoms (dyspnea, crackles, and edema) are consistent with fluid overload and dilutional hyponatremia.